Volume 30, Issue 168, February 2026

Infections in Patients with Multiple Myeloma: Epidemiology, Risk Prediction, and Prevention Strategies - A Review

Kacper Kopeć^1♦, Marta Ciszewska², Gabriela Szubert³, Małgorzata Gasińska-Franas⁴

¹Department of Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
²Medical University of Lodz, Al. Tadeusza Kościuszki 4, 90-419 Łódź, Poland
³Medical University of Lodz, Al. Tadeusza Kościuszki 4, 90-419 Łódź, Poland
⁴Medical University of Lodz, Al. Tadeusza Kościuszki 4, 90-419 Łódź, Poland

^♦Corresponding author
Kacper Kopeć, Department of Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland

ABSTRACT

Infections are a leading cause of morbidity and premature mortality in patients with multiple myeloma (MM). Patients with MM face a 5–7-fold increased risk of bacterial infections and even a 10-fold higher risk of viral infections compared with the general population. Impaired humoral responses, lymphocyte dysfunction, or hypogammaglobulinemia contribute to secondary immunodeficiency. The risk of infections is particularly high during the first months after diagnosis and remains elevated while receiving treatment. The introduction of novel therapies, including targeted agents such as bortezomib, daratumumab, as well as CAR-T and bispecific antibodies, has changed the management of MM by bringing new infection related challenges. Risk prediction tools, antimicrobial prophylaxis, vaccination strategies and monitoring viral infections are essential in a preventive approach. This review summarizes current evidence on the epidemiology, risk factors, pathogenic mechanisms, and recommendations for the prevention and management of infectious complications in patients with MM.

Keywords: multiple myeloma, infections, treatment strategies, epidemiology, prophylaxis

Medical Science, 2026, 30, e31ms3818

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DOI: https://doi.org/10.54905/disssi.v30i168.e31ms3818

Published: 15 February 2026